ERS | monograph Introduction David S. Hui1,2, Giovanni A. Rossi3 and Sebastian L. Johnston4 Viral respiratory tract infections are important and common causes of morbidity and mortality worldwide. Over the past two decades, several novel viral respiratory infections with epidemic potential that threaten global health security have emerged. Human cases of the highly pathogenic avian influenza A(H5N1) were initially detected in Hong Kong in 1997, before spreading to other parts of Asia, the Middle East, Europe and Africa, with a case fatality rate close to 60%. Influenza A(H1N1)pdm09 virus first emerged in 2009 as a novel swine-origin strain, which rapidly led to a pandemic and has remained a common circulating strain in many parts of the world. Human infections with the novel avian influenza A(H7N9) virus were first reported in mainland China in March 2013 and the infection has since spread to Hong Kong and Taiwan. Avian influenza A(H5N1) and A(H7N9) viruses have continued to circulate widely in some poultry populations and infect humans sporadically sporadic human cases of avian A(H5N6), A(H10N8) and A(H6N1) have also emerged. In March 2003, the World Health Organization (WHO) issued a global alert about an emerging SARS caused by a novel CoV, which rapidly spread from mainland China via Hong Kong to at least 29 countries/regions and finally ended in July 2003, with 8096 probable cases and 774 deaths. Since its first discovery in a patient who died of severe pneumonia in Saudi Arabia in 2012, MERS-CoV has spread to 26 countries. The mortality rates of MERS-CoV infection are high, especially in those with comorbid disease. In addition to the threat of novel CoV and avian influenza viruses, the burden of the common respiratory viruses, such as seasonal influenza, RSV and human rhinoviruses (HRV), on healthcare utilisation remains high, and yet is also a largely unmet medical need. This highlights the urgent need for developing more effective therapies in order to reduce the morbidity and mortality associated with novel threats, as well as the regular offenders. The Platform for European Preparedness Against (Re-)emerging Epidemics (PREPARE) ( is an European Union funded network aiming to harmonise large-scale clinical research studies on infectious diseases, and provide real-time evidence for clinical management of patients and for informing public health responses. To advance our understanding of the clinical, epidemiological and scientific aspects of important respiratory viruses and facilitate planning of research studies on emerging Copyright ©ERS 2016. Print ISBN: 978-1-84984-069-9. Online ISBN: 978-1-84984-070-5. Print ISSN: 2312-508X. Online ISSN: 2312-5098. Correspondence: David S. Hui, Dept of Medicine, Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, Hong Kong. E-mail: 1 Dept of Medicine and Therapeutics, The Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, Hong Kong. 2 Stanley Ho Center for Emerging Infectious Disease, The Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, Hong Kong. 3 Dept of Pediatrics, Pulmonary and Allergy Disease Units, Istituto G. Gaslini, Genoa, Italy. 4 National Heart & Lung Institute, Imperial College London, London, UK. ERS Monogr 2016 72: ix–x. DOI: 10.1183/2312508X.10008516 ix
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